Individual provider Active NPI

Sharlene Vanessa Johnson, DPT

  • Physical Therapist
  • Douglasville, GA
National Provider Identifier
1336663103
Registry record updated Aug 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT013074 Issued in GA
Practice address
8509 Hospital Dr
Douglasville, GA 30134-2414
Phone
(770) 947-5440
NPI assigned
Aug 2, 2017
Last updated
Aug 2, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT013074 GA Primary

Addresses

Primary practice location

8509 Hospital Dr
Douglasville, GA 30134-2414

Mailing address

4182 Groveland Park Dr
Powder Springs, GA 30127-1791
Phone (908) 242-0585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT013074GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Physical Therapy, LLC CurrentSince Jan 11, 2022 Accepting new patients
Select Rehabilitation, LLC Physical Therapist CurrentSince Feb 14, 2024 Accepting new patients
Emory Physical Therapy, LLC Current Accepting new patients
Emory Physical Therapy, LLC Physical Therapist CurrentSince Jan 11, 2022 Accepting new patients
Matrix Rehabilitation-Georgia Inc Past Accepting new patients

Locations

21 Ortho Ln
Atlanta, GA 30329
Phone (404) 778-2516

150 Cottage Ln
Carrollton, GA 30117
Phone (770) 830-8857

475 Irvin Ct
Decatur, GA 30030
Phone (404) 299-1581

1845 Satellite Blvd
Ste 750
Duluth, GA 30097
Phone (404) 778-6490

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501632000000",
    "number": "1336663103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4182 GROVELAND PARK DR",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301271791",
            "telephone_number": "908-242-0585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8509 HOSPITAL DR",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342414",
            "telephone_number": "770-947-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHARLENE",
        "middle_name": "VANESSA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-02",
        "last_updated": "2017-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT013074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.